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Multiple MyelomaPhase 2NCT00721734

Study of the Safety and Pharmacokinetics of Carfilzomib in Patients With Relapsed and Refractory Multiple Myeloma and Varying Degrees of Renal Function

A Phase 2 study testing Carfilzomib in people with Multiple Myeloma and Renal Insufficiency, run by Amgen at 5 sites in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The purpose of this study is to assess the influence of renal impairment on carfilzomib in patients with Multiple Myeloma (MM). Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Multiple Myeloma, Renal Insufficiency
What is being tested?
Carfilzomib
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
50 participants
Where
5 sitesUnited States
Study dates
Nov 2008to Nov 2012
Phase
Phase 2
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Written informed consent in accordance with federal, local, and institutional guidelines
  • Males and females ≥ 18 years of age
  • Multiple Myeloma
  • Documented relapsed or progressive disease (PD) after receiving at least two prior treatment regimens (induction therapy with autologous stem cell transplant and maintenance is considered a single regimen), and must have achieved a minimal response or better to at least one of the regimens
  • Current measurable disease, as indicated by one or more of the following:
  • Serum M-protein ≥ 0.5 g/dL
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  • Urine M-protein ≥ 200 mg/24 hours
  • Serum Free Light Chain (FLC) assay: Involved FLC level ≥ 10 mg/dL provided serum FLC ratio is abnormal
  • Life expectancy of more than three months
  • Eastern Cooperative Oncology Group (ECOG) Performance Status 0-2
  • Adequate hepatic function, with bilirubin < 2 times the upper limit of normal (ULN) and alanine aminotransferase (ALT) < 3 times ULN
  • Total white blood cell (WBC) count ≥ 2,000/mm³
  • Absolute neutrophil count (ANC) ≥ 1,000/mm³
  • Hemoglobin ≥ 7 gm/dL
  • Subjects may receive red blood cell (RBC) transfusions or supportive care with erythropoietin or darbepoetin in accordance with institutional guidelines
  • Platelet count ≥ 30,000/ mm³
  • Female subjects of child-bearing potential must have a negative serum pregnancy test within seven days of the first dose and agree to use dual methods of contraception during and for 3 months following last dose of drug. Post menopausal females (> 45 years old and without menses for > 1 year) and surgically sterilized females are exempt from a pregnancy test
  • Male subjects must use an effective barrier method of contraception during study and for three months following the last dose if sexually active with a female of child-bearing potential

Who cannot join

  • Glucocorticoid therapy in a dose equivalent to prednisone ≥ 20 mg/day within 14 days prior to first dose of study drug
  • POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, monoclonal protein, and skin changes)
  • Plasma cell leukemia
  • Chemotherapy with approved or investigative anticancer therapeutics, including steroid therapy dose as defined above, within 14 days prior to first dose of study drug or antibody therapy within 6 weeks prior to first dose of study drug
  • Radiation therapy or immunotherapy within 3 weeks prior to first dose; localized radiation therapy within 1 week prior to first dose
  • Participation in an investigational therapeutic study within 14 days prior to first dose of study drug
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  • Prior carfilzomib treatment
  • Pregnant or lactating females
  • Major surgery within 3 weeks prior to first dose of study drug
  • Congestive heart failure (New York Heart Association Class III to IV), symptomatic ischemia, conduction abnormalities or myocardial infarction in the three months prior to first dose of study drug
  • Uncontrolled hypertension
  • Recent history of acute active infection requiring systemic antibiotics, antivirals, or antifungals within two weeks prior to first dose of study drug
  • Known or suspected human immunodeficiency virus (HIV) infection, known HIV seropositivity
  • Active hepatitis A, B, or C infection
  • Other malignancy within the past 3 years except a) adequately treated basal cell or squamous cell skin cancer, b) carcinoma in situ of the cervix, or c) prostate cancer < Gleason Grade 7 with stable prostate specific antigen (PSA) levels
  • Any clinically significant medical or psychiatric disease or condition that, in the Investigator's opinion, may interfere with protocol adherence or a subject's ability to give informed consent
  • Significant neuropathy (Grade 3, Grade 4, or Grade 2 with pain) at the time of the first dose and/or within 14 days prior to enrollment
  • Subjects in whom the required program of oral hydration and intravenous fluid hydration is contraindicated, e.g., due to preexisting pulmonary or cardiac impairment
  • Subjects with pleural effusions requiring routine thoracentesis or ascites requiring routine paracentesis
  • Subjects with a known contraindication to receiving dexamethasone or allopurinol
  • Receipt of granulocyte- and granulocyte/ macrophage- colony stimulating factor (G-CSF and GM-CSF) within 1 week prior to first dose of study drug
  • Receipt of pegylated G-CSF within 2 weeks prior to first dose of study drug
  • RBC and platelet transfusions within 7 days prior to first dose of study drug
  • Subjects with known or suspected cardiac amyloidosis
  • Subjects with myelodysplastic syndrome
  • Subjects undergoing peritoneal dialysis

Trial locations and contacts

5 sites in 1 country.

5 sites in 1 country

United States5 sites
  • University of Maryland Medical Center

    Baltimore, Maryland, 21201

  • Barbara Ann Karmanos Cancer Institute

    Detroit, Michigan, 48201

  • Cornell University

    New York, New York, 10021

  • University of California- San Francisco

    San Francisco, California, 94143

  • Washington University School of Medicine

    St Louis, Missouri, 63110

Other trials in United States

About this study

Official title: Phase 2 Study of the Safety and Pharmacokinetics of Carfilzomib in Subjects With Relapsed and Refractory Multiple Myeloma and Varying Degrees of Renal Function

The purpose of this study is to assess the influence of renal impairment on carfilzomib in patients with Multiple Myeloma (MM).

Being tested
Carfilzomib
Keywords
Myeloma, Renal Insufficiency, Proteasome, Hematological, carfilzomib, PR-171
Medical subject headings
Multiple Myeloma, Renal Insufficiency, Neoplasms, Plasma Cell

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • CarfilzomibDrug

    Also called PR-171, Kyprolis®

    Carfilzomib was administered intravenously (IV) at a rate of approximately 10 mL/minute.

Study groups in NCT00721734
Study groupRoleWhat they receive
CarfilzomibExperimentalCarfilzomib, 15 mg/m², was administered intravenously (IV) on Days 1, 2, 8, 9, 15, and 16 of repeated 28-day cycles for a maximum of 12 cycles. If the 15 mg/m² dose was tolerated the dose could be increased to 20 mg/m² starting at Cycle 2. If 20 mg/m² was tolerated, an additional dose escalation to 27 mg/m² was allowed at Cycle 3 or at subsequent cycles.
Receives: Drug: Carfilzomib

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Clearance (CL) of Carfilzomib on Day 1 of Cycle 1

    Plasma concentrations of carfilzomib was determined by a validated liquid chromatography tandem mass spectrometry (LC MS/MS) method. The lower limit of quantitation (LLOQ) was 0.300 ng/mL. Concentration values that were below the LLOQ (BLQ) were set to zero. Pharmacokinetic (PK) parameters were calculated from the individual plasma concentrations of carfilzomib using a noncompartmental method.

    Measured: Cycle 1, Day 1 before dosing, at the end of the injection, 5, 15, 30, and 60 minutes, and 1.5, 2, 4, 6 and 24 hours postdose.

Secondary outcomes (20)
  1. Clearance (CL) of Carfilzomib on Day 15 of Cycle 1

    Measured: Cycle 1, Day 15 before dosing, at the end of the injection, 5, 15, 30, and 60 minutes, and 1.5, 2, 4, 6 and 24 hours postdose.

  2. Clearance (CL) of Carfilzomib on Day 15 of Cycle 2

    Measured: Cycle 2, Day 15, before dosing, at the end of the injection, 5, 15, 30, and 60 minutes, and 1.5, 2, 4, 6 and 24 hours postdose.

  3. Maximum Observed Plasma Concentration of Carfilzomib on Day 1 of Cycle 1

    Measured: Cycle 1, Day 1, before dosing, at the end of the injection, 5, 15, 30, and 60 minutes, and 1.5, 2, 4, 6 and 24 hours postdose.

  4. Maximum Observed Plasma Concentration of Carfilzomib on Day 15 of Cycle 1

    Measured: Cycle 1, Day 15 before dosing, at the end of the injection, 5, 15, 30, and 60 minutes, and 1.5, 2, 4, 6 and 24 hours postdose.

  5. Maximum Observed Plasma Concentration of Carfilzomib on Day 15 of Cycle 2

    Measured: Cycle 2, Day 15 before dosing, at the end of the injection, 5, 15, 30, and 60 minutes, and 1.5, 2, 4, 6 and 24 hours postdose.

  6. Area Under the Plasma Curve Extrapolated to Infinity (AUCinf) for Carfilzomib on Day 1 of Cycle 1

    Measured: Cycle 1, Day 1, before dosing, at the end of the injection, 5, 15, 30, and 60 minutes, and 1.5, 2, 4, 6 and 24 hours postdose.

  7. Area Under the Plasma Curve Extrapolated to Infinity (AUCinf) for Carfilzomib on Day 15 of Cycle 1

    Measured: Cycle 1, Day 15 before dosing, at the end of the injection, 5, 15, 30, and 60 minutes, and 1.5, 2, 4, 6 and 24 hours postdose.

  8. Area Under the Plasma Curve Extrapolated to Infinity (AUCinf) for Carfilzomib on Day 15 of Cycle 2

    Measured: Cycle 2, Day 15 before dosing, at the end of the injection, 5, 15, 30, and 60 minutes, and 1.5, 2, 4, 6 and 24 hours postdose.

  9. Area Under the Concentration Time Curve to the Last Measurable Concentration (AUClast) for Carfilzomib on Day 1 of Cycle 1

    Measured: Cycle 1, Day 1 before dosing, at the end of the injection, 5, 15, 30, and 60 minutes, and 1.5, 2, 4, 6 and 24 hours postdose.

  10. Area Under the Concentration Time Curve to the Last Measurable Concentration (AUClast) for Carfilzomib on Day 15 of Cycle 1

    Measured: Cycle 1, Day 15 before dosing, at the end of the injection, 5, 15, 30, and 60 minutes, and 1.5, 2, 4, 6 and 24 hours postdose.

  11. Area Under the Concentration Time Curve to the Last Measurable Concentration (AUClast) for Carfilzomib on Day 15 of Cycle 2

    Measured: Cycle 2, Day 15 before dosing, at the end of the injection, 5, 15, 30, and 60 minutes, and 1.5, 2, 4, 6 and 24 hours postdose.

  12. Percentage of Carfilzomib Excreted Via Renal Elimination on Day 1 of Cycle 1

    The percentage of carfilzomib excreted in urine was calculated as the total amount excreted over 24 hours/dose.

    Measured: Cycle 1, Day 1, 0-5 and 5-24 hours post-dose

  13. Percentage of Carfilzomib Excreted Via Renal Elimination on Day 15 of Cycle 1

    The percentage of carfilzomib excreted in urine was calculated as the total amount excreted over 24 hours/dose.

    Measured: Cycle 1, Day 15, 0-5 and 5-24 hours post-dose

  14. Percentage of Carfilzomib Metabolites Excreted Via Renal Elimination on Day 1 of Cycle 1

    The percentage of the metabolites of carfilzomib (PR-389/M14 and PR-413/M15) excreted in urine was calculated as the total amount excreted over 24 hours/dose.

    Measured: Cycle 1, Day 1, 0-5 and 5-24 hours post-dose

  15. Percentage of Carfilzomib Metabolites Excreted Via Renal Elimination on Day 15 of Cycle 1

    The percentage of the metabolites of carfilzomib (PR-389/M14 and PR-413/M15) excreted in urine was calculated as the total amount excreted over 24 hours/dose.

    Measured: Cycle 1, Day 15, 0-5 and 5-24 hours post-dose

  16. Plasma Protein Binding (PPB) of Carfilzomib

    The plasma protein binding (PPB) of carfilzomib in plasma samples was determined using a rapid equilibrium dialysis (RED) device. Data are averages of the 3 time points (Cycle 1 Day 1, Cycle 1 Day 15, and Cycle 2 Day 15).

    Measured: End of injection and 5 minutes post-dose on Cycle 1 Day 1, Cycle 1 Day 15, and Cycle 2 Day 15

  17. Overall Response Rate (ORR)

    ORR is defined as the percentage of participants with a best response of stringent complete response (sCR), complete response (CR), very good partial response (VGPR), or partial response (PR) per the International Uniform Response Criteria for Multiple Myeloma.

    sCR: CR as defined below plus normal serum free light chain (sFLC) ratio and absence of clonal plasma cells in bone marrow by immunohistochemistry or immunofluorescence; CR: absence of M-protein in serum and urine confirmed by immunofixation and < 5% plasma cells in the bone marrow; VGPR: serum and urine M-proteins detectable by immunofixation, but not by electrophoresis or a ≥ 90% reduction in serum M-protein from baseline, plus a urine M-protein level of < 100 mg/24 hours; PR: reduction of M-protein in serum of ≥ 50% and in urine of ≥ 90% from baseline. If serum and urine M-protein were not measureable at baseline, a ≥ 50% decrease in the difference between involved and uninvolved sFLC levels from baseline.

    Measured: From first dose until 30 days after the last dose; median duration of treatment across all groups was 121 days.

  18. Clinical Benefit Rate (CBR)

    Clinical benefit rate is defined as the percentage of participants whose best response was sCR, CR, VGPR, PR, or minimal response (MR), where MR is defined by the European Group for Blood and Marrow Transplant (EBMT) criteria as a reduction of M-protein in serum of 25% to 49% and in urine of 50% to 89% from baseline, maintained for at least 6 weeks.

    Measured: From first dose until 30 days after the last dose; median duration of treatment across all groups was 121 days.

  19. Duration of Response

    Duration of Response is defined as the time from first evidence of PR or better to confirmation of disease progression or death.

    Progressive disease was defined as any of the following:

    • An increase of more than 25% from nadir in any one of the following:
    • M-protein in serum (the absolute increase had to be ≥ 0.5 g/dL);
    • Urine (the absolute increase had to be ≥ 200 mg/24 hours);
    • The difference between involved and uninvolved sFLC (the absolute increase in the concentration of involved light chain had to be > 10 mg/dL);
    • ≥ 10% bone marrow infiltration by plasma cells;
    • Increased size of pre-existing bone lesions or plasmacytomas or new bone lesions or plasmacytomas.

    Median duration of response was estimated using the Kaplan-Meier method.

    Measured: Participants were followed for disease progression for up to 2 years.

  20. Time to Progression (TTP)

    Time to Progression is defined as the time from first dose of carfilzomib to disease progression. Median TTP was estimated using Kaplan-Meier methods.

    Measured: Participants were followed for disease progression for up to 2 years.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted24 Jul 2008 (estimated)
  2. Study startNov 2008
  3. Primary completionNov 2012
  4. Study completionNov 2012

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
50 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00721734
Sponsor's protocol ID
PX-171-005
Status last verified
Apr 2017
First submitted
22 Jul 2008
Last updated
2 May 2017
Data monitoring committee
No

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Carfilzomib in people with Multiple Myeloma and Renal Insufficiency, run by Amgen at 5 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 18 inclusion and 26 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 2 May 2017. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 5 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 9 Dec 2015). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Clearance (CL) of Carfilzomib on Day 1 of Cycle 1 (time frame: Cycle 1, Day 1 before dosing, at the end of the injection, 5, 15, 30, and 60 minutes, and 1.5, 2, 4, 6 and 24 hours postdose.). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 2 May 2017.

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